Healthcare Provider Details

I. General information

NPI: 1144553199
Provider Name (Legal Business Name): SHAKEEL A BAHADUR M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2009
Last Update Date: 03/26/2026
Certification Date: 03/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

730 W HIGH ST STE 240
LIMA OH
45801-3920
US

IV. Provider business mailing address

770 W HIGH ST STE 240
LIMA OH
45801-5906
US

V. Phone/Fax

Practice location:
  • Phone: 419-996-2686
  • Fax: 419-996-2687
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number35-094267
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number35-094267
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number35-094267
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: